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EP3834747B1 - Medizinisches instrument - Google Patents

Medizinisches instrument Download PDF

Info

Publication number
EP3834747B1
EP3834747B1 EP19890383.3A EP19890383A EP3834747B1 EP 3834747 B1 EP3834747 B1 EP 3834747B1 EP 19890383 A EP19890383 A EP 19890383A EP 3834747 B1 EP3834747 B1 EP 3834747B1
Authority
EP
European Patent Office
Prior art keywords
clip
rod
medical apparatus
clamp
piece
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP19890383.3A
Other languages
English (en)
French (fr)
Other versions
EP3834747A4 (de
EP3834747C0 (de
EP3834747A1 (de
Inventor
Bingchao ZHOU
Hui Zhang
Yunfeng Du
Dianchen LIU
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Suzhou IntoCare Medical Technology Co Ltd
Original Assignee
Suzhou IntoCare Medical Technology Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Suzhou IntoCare Medical Technology Co Ltd filed Critical Suzhou IntoCare Medical Technology Co Ltd
Publication of EP3834747A1 publication Critical patent/EP3834747A1/de
Publication of EP3834747A4 publication Critical patent/EP3834747A4/de
Application granted granted Critical
Publication of EP3834747B1 publication Critical patent/EP3834747B1/de
Publication of EP3834747C0 publication Critical patent/EP3834747C0/de
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00734—Aspects not otherwise provided for battery operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02—Operational features
    • A61B2560/0266—Operational features for monitoring or limiting apparatus function
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90—Identification means for patients or instruments, e.g. tags
    • A61B90/98—Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders

Definitions

  • the present disclosure relates to a medical apparatus, belonging to the technical field of medical apparatus.
  • CA3009420A1 provides a reposable surgical clip applier which includes a handle assembly having a housing, a trigger and a drive assembly including a drive rod.
  • the reposable surgical clip applier further includes an outer tube assembly disposed on a distal end of the housing and extending distally therefrom, and a clip cartridge assembly selectively connectable to the distal end of the outer tube assembly.
  • a method of assembling a reposable surgical clip applier is also provided.
  • US2010/057102A1 discloses an apparatus for application of surgical clips to body tissue.
  • the apparatus includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly.
  • US2014/005695A1 discloses a surgical device for clipping tissue.
  • the surgical device includes a replaceable cartridge comprising a stack of clips contained therein and a firing drive configured to reciprocating eject, or deploy, the clips from the cartridge. After the clips have been deployed from the cartridge, a blocking member is positioned to impede or block the firing drive.
  • the present disclosure has the following beneficial effects: the structure is simple and operation is convenient; by constructing limiting protections, the medical apparatus has higher safety factor, and the probability of failure due to occurrence of a single fault is effectively reduced, thus lowering operational risk.
  • the firing rod is driven to move forwards or backwards so as to control the opening or closing of the clamp, thereby achieving the purposes of structure simplification, quick firing and efficiency improvement.
  • a medical apparatus in a preferred embodiment of the present disclosure includes a clamp 3, a work head 2, and a handle 1.
  • the work head 2 is connected to both the clamp 3 and the handle 1.
  • the work head 2 includes a casing 10, a firing forcing member arranged in the casing 10, a firing rod 21 connected to the firing forcing member, a receiving cavity 22 arranged at a side of the firing rod 21, and a clip-cartridge assembly 23 arranged in the receiving cavity 22 and configured for delivering ligation clips 231 to the clamp 3.
  • the firing rod 21 is connected to the firing forcing member and the clamp 3 respectively, and the firing forcing member drives the firing rod 21 to move so as to open or close the clamp 3.
  • An inner cavity 11 communicating with the receiving cavity 22 is formed in the casing 10, and the casing 10 has an opening 12 formed at a side of the inner cavity 11.
  • the clip-cartridge assembly 23 passes through the inner cavity 11 via the opening 12 to be inserted into the receiving cavity 22.
  • a cover 13 connected to the opening 12 is further disposed on the casing 10, and the cover 13 is opened or closed relative to the opening 12.
  • the clamp 3 includes a movable jaw 31 and a fixed jaw 32, the movable jaw 31 is connected with the fixed jaw 32 by a rotating shaft 33, and the firing rod 21 is connected to the rotating shaft 33.
  • the firing rod 21 moves forward or backward to control the opening or closing of the movable jaw 31 relative to the fixed jaw 32.
  • the clip-cartridge assembly 23 includes ligation clips 231, a clip-cartridge slot 232 configured for accommodating the ligation clips 231, and a clip-pushing piece 233 covering the clip-cartridge slot 232.
  • the clip-pushing piece 233 is provided with a plurality of ratchet facing towards the clamp 3, and the ratchet abut against the ligation clips 231 to push the ligation clips 231 to move towards the clamp 3 under the driving of a driving rod 26.
  • Each ligation clip 231 includes a first clip arm 2311, a second clip arm 2312, and a connector 2313 configured for connecting the first clip arm 2311 and the second clip arm 2312.
  • Each first clip arm 2311 is further provided with a protrusion 2314.
  • the protrusion allows the ratchet to abut thereon, so as to push the ligation clip 231 to move in the clip-cartridge slot 232 and move towards the clamp 3.
  • the protrusion 2314 is in a shape of cylinder and is arranged at an end, away from the connector 2313, of the first clip arm 2311.
  • the ligation clip 231 is moved in the clip-cartridge slot 232 along a moving direction, and the protrusion 2314 has an inclined surface extending along the moving direction of the ligation clip 231.
  • the medical apparatus further includes a driving rod 26 arranged on the clip-cartridge assembly 23; a clip-pushing forcing member is further arranged on the handle 1, and the clip-pushing forcing member is connected to the driving rod 26, so as to drive the driving rod 26 to push the clip-pushing piece 233 to move.
  • the clip-pushing piece 233 is disposed on the clip-cartridge slot 232 and connected to the clip-pushing piece 233.
  • one end of the clip-pushing piece 233 is provided with a mounting part 2331, and the driving rod is connected to the clip-pushing piece 233 through the mounting part 2331.
  • a brake member 27 is detachably arranged between the driving rod 26 and the clip-cartridge assembly 23 to limit the relative movement between the driving rod 26 and the clip-cartridge assembly 23.
  • a side of the clip-cartridge slot 232 is provided with a bending piece 2321, and the driving rod 26 has an abutting surface facing away from the clamp 3.
  • the bending piece 2321 abuts on the abutting surface through the brake member 27.
  • the abutting surface is concave to form a groove for receiving the bending piece 2321; alternatively, the abutting surface is a flat surface.
  • the abutting surface is not limited to the above-mentioned embodiments, as long as the abutting surface abuts against the bending piece 2321.
  • the driving rod 26 is provided with a latching groove 263, and the brake member 27 is provided with a latching block 271 cooperated with the latching groove 263 in a latching mode.
  • the brake member 27 is M-shaped, and inward bending pieces of the M-shaped brake member 27 are provided with the latching blocks 271. Both sides of one end of the driving rod 26 are provided with the latching grooves 263.
  • the M-shaped brake member 27 fastens the driving rod 26 and the clip-cartridge slot 232 after the latching blocks 271 slide into the latching grooves 263.
  • the clip-pushing forcing member includes a positioning block 24, a connecting assembly 25 connected to the positioning block 24, and a driving assembly 28 connected to the connecting assembly 25.
  • the driving assembly 28 drives and pushes the connecting assembly 25 so as to drive the positioning block 24 to move.
  • the positioning block 24 is arranged in the inner cavity 11.
  • the driving rod 26 is provided with a clamping part, and the positioning block 24 cooperates with the clamping part to restrict the driving rod 26 from moving towards the clamp 3.
  • the driving rod 26 includes a main body part 261 and a bending part 262 bent outwards from a side of the main body part 261.
  • the clamping part includes a latching hook 2621 arranged on the bending part 262 and a first bump 2611 arranged on the main body part 261.
  • the positioning block 24 is arranged between the latching hook 2621 and the first bump 2611.
  • the positioning block 24 is provided with a first through hole allowing the clip-cartridge assembly 23 to enter the receiving cavity 22, and the latching hook 2621 passes through the first through hole to abut against the positioning block 24.
  • the latching hook 2621 is of a slope structure.
  • the slope structure has an inclined plane and a vertical plane connected to the inclined plane, and the vertical plane is clamped with the positioning block 24. Taking the direction of arrow "a" in the figure as the front side, the slope structure inclines upwards from the front side to the rear side. The slope structure passes through the first through hole under the compression of the first through hole, and then elastically recovers to abut against the positioning block 24.
  • the first bump 2611 and the latching hook 2621 are arranged in different planes to better fix the clip-cartridge assembly 23.
  • the first bump 2611 and the latching hook 2621 may also be arranged in the same plane, which is not limited here.
  • the medical apparatus further includes a limiting member.
  • the limiting member is configured for preventing the clip-cartridge assembly 23 and/or the driving assembly 28 from exceeding the stroke range.
  • the limiting member includes a first stopper, a second stopper 43 and a second bump 2322.
  • the first stopper is disposed on the casing 10 at a side of the inner cavity 11, and the first stopper abuts against an end of the clip-cartridge assembly 23 to restrict the clip-cartridge assembly 23 from moving towards the handle 1.
  • the second stopper 43 is disposed in the inner cavity 11.
  • the second bump 2322 is disposed on the clip-cartridge slot 232 and clamped with the second stopper 43.
  • the second bump 2322 is located between the first stopper and the second stopper 43.
  • the second stopper 43 is clamped with the second bump 2322 to restrict the movement of the clip-cartridge assembly 23 towards the clamp 3.
  • the arrangement of the first stopper, the second stopper 43 as well as the second bump 2322 forms the first positional limiting protection for the clip-cartridge assembly 23.
  • the medical apparatus stops working.
  • the limiting member includes a threaded rod 285 arranged on the driving assembly 28.
  • the threaded rod 285 is connected to the clip-cartridge assembly 23 through the connecting assembly 25.
  • the threaded rod 285 is in threaded connection with the connecting assembly 25.
  • the driving assembly 28 drives the threaded rod 285 to push the connecting assembly 25 so as to drive the clip-cartridge assembly 23 to feed clips.
  • the driving assembly 28 is disposed in the handle 1.
  • the driving assembly 28 further includes a driving motor 281, a first gear 282 connected to the driving motor 281, a second gear 283 engaged with the first gear 282 along a vertical direction, and a nut 284 connected to the second gear 283.
  • the nut 284 is sleeved with the second gear 283.
  • the driving motor 281 is provided with an output shaft, and the output shaft is sleeved with the first gear 282.
  • the output shaft transmits the speed and torque output from the driving motor 281 to the first gear 282 and the second gear 283, such that the radial rotation is converted into axial rotation.
  • the driving assembly 28 is in threaded connection with the connecting assembly 25 through the threaded rod 285.
  • the limitation on the length of the threaded rod 285 serves as a third positional limiting protection for the medical apparatus.
  • the limiting member includes an electronic switch arranged on the clip-cartridge assembly 23, and a receiver arranged in the inner cavity 11 and coupled with the electronic switch.
  • the electronic switch cooperates with the receiver to form a second positional limiting protection for the clip-cartridge assembly 23.
  • the limiting member includes two electronic switches, namely, a first electronic switch and a second electronic switch.
  • the first electronic switch and the second electronic switch are arranged on the two sides of the clip-cartridge assembly 23 to prevent the clip-cartridge assembly 23 from exceeding the stroke range.
  • the electronic switches are conventional position switches, which are not described in detail here.
  • the electronic switches may also be arranged on the connecting assembly 25 and/or the positioning block 24, which is determined according to actual application requirements and not specifically limited here.
  • the connecting assembly 25 includes a connecting piece 251 and a connecting rod 252.
  • the connecting rod 252 connects the connecting piece 251 and the positioning block 24.
  • the threaded rod 285 is connected to the connecting piece 251.
  • the driving assembly 28 drives the threaded rod 285 to move forwards, so that the connecting piece 251 drives the positioning block 24 to move, thereby driving the clip-cartridge assembly 23 to move towards the clamp 3.
  • the connecting piece 251 is provided with a second through hole and a three through hole.
  • the threaded rod 285 is in threaded connection with the third through hole, and the clip-cartridge assembly 23 passes through the second through hole to enter the receiving cavity 22.
  • the connecting assembly 25 may further include a connecting sleeve 253, and the connecting sleeve 253 is sleeved with the connecting piece 251.
  • the connecting rod 252 connects the connecting sleeve 253 and the positioning block 24.
  • the firing forcing member includes a toggle piece 41 and a movable member 42.
  • the toggle piece 41 has a first connecting part, a second connecting part, and a third connecting part.
  • the first connecting part is axially connected to the casing 10
  • the second connecting part is connected to the connecting rod 252
  • the third connecting part is connected to the movable member 42.
  • the positioning block 24 is clamped with the toggle piece 41.
  • the first connecting part, the second connecting part and the third connecting part form a shape of triangle, which can better drive the firing rod 21 to move forwards or backwards in a situation that the toggle piece 41 leans forwards or backwards.
  • a guide groove is formed in the casing 10, and the movable member 42 is disposed in the guide groove.
  • the movable member 42 includes a spring 421 and a spring rod 422.
  • the spring 421 is fixedly arranged in the guide groove and configured for restoring the toggle piece 41.
  • the spring rod 422 is arranged in the spring 421.
  • One end of the spring rod 422 is connected to the toggle piece 41, and the other end of the spring rod 422 abuts against the spring 421.
  • the toggle piece 41 presses backwards to deform the spring 421.
  • the spring 421 drives the toggle piece 41 to recover by using the elastic force in itself.
  • the firing forcing member may be a firing handle, and the firing handle is directly connected to the firing rod 21 to drive the firing rod 21 to achieve a firing action, which is not limited here.
  • the medical apparatus further includes a rotating handle 4 configured for connecting the handle 1 with the work head 2.
  • the angle of the clamp 3 can be regulated by adjusting the rotating handle 4, thereby reducing the difficulty of adjusting the angle of the clamp 3 due to angle limitation during operation.
  • the second stopper 43 and the guide groove are both disposed on the rotating handle 4.
  • the handle 1 includes a shell 16, a control circuit arranged in the shell 16, a first switch 14 and a second switch 15; the first switch 14 and the second switch 15 are coupled to the control circuit.
  • the first switch 14 is configured for driving the driving rod 26 and the firing rod 21 to move forwards.
  • the second switch 15 is configured for driving the driving rod 26 and the firing rod 21 to move backwards.
  • the driving assembly 28 is coupled to the control circuit.
  • the handle 1 further includes a battery coupled to the control circuit and a display disposed on the handle 1.
  • a control module for the driving assembly 28, a work-head identification module, a stroke control module for clip-cartridge feeding and firing, a battery detection-control module, a machine working-state indication module, and a data recording-storage module are disposed in the control circuit and are controlled by a single chip processor.
  • control module for the driving assembly 28 is configured for controlling the start and stop of the threaded rod 285.
  • the first switch 14 and the second switch 15 arranged under the handle 1 are isolated from the interior of a host of a clip applicator.
  • the driving assembly 28 is controlled by moving magnets inside the first switch 14 and the second switch 15 close to or away from a Hall switch sealed in the handle 1.
  • the identification module for work head 2 is configured for transmitting the type data of the work head 2 through a terminal arranged on the receiving cavity 22, and then instructing the control circuit to call corresponding working programs.
  • the stroke control module for clip-cartridge feeding and firing realizes clip feeding and clip firing actions by means of a signal identification module, an electronic switch position control module and a safety module installed in the work head 2.
  • the battery detection module in the battery detection-control module has a function for detecting the battery power and monitors the battery power before and during the surgical operation, in order to ensure that the battery power can meet the surgical operation requirements or allow timely battery replacement.
  • the working-state indication module is configure for displaying the battery power, the connection state of the work head 2, the clip feeding completion state and the firing completion state by using a display.
  • the working process of the medical apparatus is as follows: when the first switch 14 is pressed, the driving assembly 28 drives the driving rod 26 through the threaded rod 285 to push the clip-pushing piece 233 forwards, until the ligation clips 231 are pushed into the clamp 3. At the same time, the firing rod 21 moves forwards, so that the clamp 3 is in an open state. Then, the second switch 15 is pressed, the driving assembly 28 drives the driving rod 26 through the threaded rod 285 to drive the clip-pushing piece 233 to move backwards, and the firing rod 21 moves backwards at the same time, so that the clamp 3 is closed to ligate the target tissue.
  • the clip-cartridge assembly 23 can enter or exit the cavity through the opening 12 to deliver the ligation clips 231 to the clamp 3. In this way, the clip-cartridge assembly 23 can be replaceable, and the clamp 3, the work head 2 and the handle 1 can be reused, thereby achieving the purpose of saving costs.
  • the safety factor of the medical apparatus is relatively much higher, thus the probability of failure due to a single fault is effectively reduced.
  • the firing rod 21 is driven to move forwards or backwards so as to control the opening or closing of the clamp 3; in this way, the firing rod 21, the clamp 3, and the clip-cartridge assembly 23 can be operated simultaneously without the need to be operated separately and individually, thereby achieving the purposes of structure simplification, quick firing and efficiency improvement.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Claims (15)

  1. Medizinische Vorrichtung, umfassend eine Klemme (3), einen Arbeitskopf (2) und einen Griff (1), wobei der Arbeitskopf (2) mit der Klemme (3) und dem Griff (1) verbunden ist und der Arbeitskopf (2) Folgendes umfasst: ein Gehäuse (10), ein in dem Gehäuse (10) angeordnetes Element zum Ausüben einer Abschusskraft, eine Abschussstange, die mit dem Element zum Ausüben einer Abschusskraft verbunden ist, einen Aufnahmehohlraum (22), der an einer Seite der Abschussstange (21) angeordnet ist, und eine Clip-Kartuschen-Baugruppe (23), wobei die Clip-Kartuschen-Baugruppe in dem Aufnahmehohlraum (22) angeordnet ist und zum Zuleiten von Ligaturclips (231) zu der Klemme (3) ausgestaltet ist; ein innerer Hohlraum (11), der mit dem Aufnahmehohlraum (22) in Verbindung steht, in dem Gehäuse (10) ausgebildet ist; und das Element zum Ausüben einer Abschusskraft dazu ausgestaltet ist, die Abschussstange (21) dazu anzutreiben, sich zu bewegen, und die Abschussstange (21) dazu ausgestaltet ist, die Klemme (3) zu öffnen oder zu schließen; und die medizinische Vorrichtung ferner ein Begrenzungselement umfasst, wobei das Begrenzungselement dazu ausgestaltet ist zu verhindern, dass mindestens eine aus der Clip-Kartuschen-Baugruppe und einer Antriebsbaugruppe (28) einen Hubbereich überschreitet,
    dadurch gekennzeichnet, dass
    die Abschussstange (21) ferner mit der Klemme (3) verbunden ist;
    die Klemme (3) eine bewegliche Klemmbacke (31) und eine feste Klemmbacke (32) umfasst, wobei die bewegliche Klemmbacke (31) mit der festen Klemmbacke (32) über eine rotierende Welle (33) verbunden ist und die Abschussstange (21) mit der rotierenden Welle (33) verbunden ist,
    die Abschussstange (21) dazu ausgestaltet ist, sich vorwärts oder rückwärts zu bewegen, um das Öffnen oder Schließen der beweglichen Klemmbacke (31) relativ zu der festen Klemmbacke (32) zu steuern.
  2. Medizinische Vorrichtung nach Anspruch 1, wobei das Begrenzungselement eine mit einem Gewinde versehene Stange (285) umfasst, die auf der Antriebsbaugruppe (28) angeordnet ist, die mit einem Gewinde versehene Stange (285) über ein Verbindungsstück (251) mit der Clip-Kartuschen-Baugruppe verbunden ist und die mit einem Gewinde versehene Stange (285) in Schraubverbindung mit dem Verbindungsstück (251) steht; und die Antriebsbaugruppe (28) dazu ausgestaltet ist, die mit einem Gewinde versehene Stange (285) dazu anzutreiben, Druck auf das Verbindungsstück (251) auszuüben, und das Verbindungsstück (251) dazu ausgestaltet ist, die Clip-Kartuschen-Baugruppe dazu anzutreiben, Clips zuzuführen; wobei, wenn die Antriebsbaugruppe (28) die mit einem Gewinde versehene Stange (285) über den Hubbereich hinaus antreibt, die medizinische Vorrichtung ihre Funktion einstellt.
  3. Medizinische Vorrichtung nach Anspruch 1, wobei das Begrenzungselement einen elektronischen Schalter, der auf der Clip-Kartuschen-Baugruppe angeordnet ist, und einen Empfänger umfasst und der Empfänger in dem inneren Hohlraum (11) angeordnet und mit dem elektronischen Schalter gekoppelt ist; wobei, wenn der Empfänger ein Signal von dem elektronischen Schalter empfängt, die medizinische Vorrichtung ihre Funktion einstellt.
  4. Medizinische Vorrichtung nach Anspruch 1, wobei das Begrenzungselement einen ersten Anschlag, der auf dem Gehäuse (10) an einer Seite des inneren Hohlraums (11) angeordnet ist, und einen zweiten Anschlag (43), der in dem inneren Hohlraum (11) angeordnet ist, sowie eine zweite Ausbuchtung (2322) umfasst; die zweite Ausbuchtung (2322) auf der Clip-Kartuschen-Baugruppe angeordnet und an den zweiten Anschlag (43) geklemmt ist; und die zweite Ausbuchtung (2322) sich zwischen dem ersten Anschlag und dem zweiten Anschlag (43) befindet; wobei, wenn ein Ende der Clip-Kartuschen-Baugruppe an den ersten Anschlag anstößt oder die zweite Ausbuchtung (2322) an den zweiten Anschlag (43) anstößt, die medizinische Vorrichtung ihre Funktion einstellt.
  5. Medizinische Vorrichtung nach einem der Ansprüche 1 bis 4, wobei die Clip-Kartuschen-Baugruppe die Ligaturclips (231), einen Clip-Kartuschen-Schlitz (232), der zum Aufnehmen der Ligaturclips (231) ausgestaltet ist, und ein Clipdrück-Stück (233), das den Clip-Kartuschen-Schlitz (232) bedeckt, umfasst; die medizinische Vorrichtung ferner eine Antriebsstange (26) umfasst, die auf der Clip-Kartuschen-Baugruppe angeordnet ist, um Druck auf das Clipdrück-Stück (233) auszuüben, damit dieses sich bewegt, das Clipdrück-Stück (233) mit einer Mehrzahl von Ratschen versehen ist, die der Klemme (3) zugewandt sind, und die Ratschen an die Ligaturclips (231) anstoßen, um Druck auf die Ligaturclips (231) auszuüben, damit diese sich, angetrieben durch die Antriebsstange (26), in Richtung der Klemme (3) bewegen.
  6. Medizinische Vorrichtung nach Anspruch 5, wobei ein Element zum Forcieren des Drückens auf die Clips auf dem Griff (1) angeordnet ist und das Element zum Forcieren des Drückens auf die Clips mit der Antriebsstange (26) verbunden ist und die Antriebsstange (26) dazu antreibt, Druck auf das Clipdrück-Stück (233) auszuüben, damit dieses sich bewegt.
  7. Medizinische Vorrichtung nach Anspruch 6, wobei ein Positionierungsblock (24) in dem inneren Hohlraum (11) angeordnet ist, die Antriebsstange (26) mit einem Klemmteil versehen ist und der Positionierungsblock (24) mit dem Klemmteil dazu zusammenwirkt, die Bewegung der Antriebsstange (26) in Richtung der Klemme (3) zu beschränken.
  8. Medizinische Vorrichtung nach Anspruch 7, wobei die Antriebsstange (26) einen Hauptkörperteil (261) und einen Biegeteil (262), der von einer Seite des Hauptkörperteils (261) hervorragt, umfasst, der Klemmteil einen Arretierhaken (2621), der auf dem Biegeteil (262) angeordnet ist, und eine erste Ausbuchtung (2611), die auf dem Hauptkörperteil (261) angeordnet ist, umfasst und der Positionierungsblock (24) zwischen dem Arretierhaken (2621) und der ersten Ausbuchtung (2611) angeordnet ist.
  9. Medizinische Vorrichtung nach Anspruch 8, wobei das Element zum Ausüben einer Abschusskraft ein Kippstück (41) und ein bewegliches Element (42) umfasst und das Kippstück (41) ein erstes Verbindungsteil, ein zweites Verbindungsteil und ein drittes Verbindungsteil aufweist;
    das erste Verbindungsteil axial mit dem Gehäuse (10) verbunden ist, das zweite Verbindungsteil mit der Verbindungsstange (252) verbunden ist, das dritte Verbindungsteil mit dem beweglichen Element (42) verbunden ist; der Positionierungsblock (24) an das Kippstück (41) geklemmt ist; und
    wenn der Positionierungsblock (24) sich vorwärts bewegt, das Kippstück (41) über das erste Verbindungsteil in Richtung der Klemme (3) rotiert, um die Abschussstange (21) dazu anzutreiben, die Klemme (3) dazu zu steuern, sich zu öffnen; und, wenn der Positionierungsblock (24) sich rückwärts bewegt, das Kippstück (41) über das erste Verbindungsteil in Richtung des Griffs (1) rotiert, um die Abschussstange (21) dazu anzutreiben, die Klemme (3) dazu zu steuern, sich zu schließen.
  10. Medizinische Vorrichtung nach Anspruch 9, wobei eine Führungsrille in dem Gehäuse (10) ausgebildet ist und das bewegliche Element (42) in der Führungsrille angeordnet ist.
  11. Medizinische Vorrichtung nach Anspruch 10, wobei das bewegliche Element (42) eine Feder (421) und eine Federstange (422) umfasst, die Feder (421) fest in der Führungsrille angeordnet und zum Wiederherstellen des Kippstücks (41) ausgestaltet ist, die Federstange (422) in der Feder (421) angeordnet ist; und ein Ende der Federstange (422) mit dem Kippstück (41) verbunden ist und das andere Ende der Federstange (422) an die Feder (421) anstößt.
  12. Medizinische Vorrichtung nach einem der Ansprüche 6-11 und Anspruch 4, wobei eine Seite des Clip-Kartuschen-Schlitzes (232) mit einem Biegestück (2321) versehen ist, die Antriebsstange (26) eine Anstoßfläche aufweist, die von der Klemme (3) abgewandt ist, und das Biegestück (2321) über ein Bremselement (27) an die Anstoßfläche anstößt.
  13. Medizinische Vorrichtung nach Anspruch 12, wobei die Anstoßfläche konkav ist, um eine Rille zum Aufnehmen des Biegestücks (2321) auszubilden.
  14. Medizinische Vorrichtung nach Anspruch 13, wobei das Bremselement (27) abnehmbar zwischen der Antriebsstange (26) und der Clip-Kartuschen-Baugruppe (23) angeordnet ist.
  15. Medizinische Vorrichtung nach Anspruch 14, wobei die Antriebsstange (26) mit einer Arretierrille (263) versehen ist und das Bremselement (27) mit einem Arretierblock (271) versehen ist, der in einem Arretiermodus mit der Arretierrille (263) zusammenwirkt.
EP19890383.3A 2018-11-30 2019-11-13 Medizinisches instrument Active EP3834747B1 (de)

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CN201811449486.1A CN111248971B (zh) 2018-11-30 2018-11-30 医疗器械
PCT/CN2019/117905 WO2020108302A1 (zh) 2018-11-30 2019-11-13 医疗器械

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CN111248972B (zh) * 2018-11-30 2021-05-28 苏州英途康医疗科技有限公司 医疗器械
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US6840945B2 (en) * 2001-02-28 2005-01-11 Microline, Inc. Medical clip applier safety arrangement
JP4266738B2 (ja) * 2003-07-02 2009-05-20 オリンパス株式会社 結紮装置
US8585717B2 (en) * 2008-08-29 2013-11-19 Covidien Lp Single stroke endoscopic surgical clip applier
CN101836882B (zh) * 2010-05-05 2011-11-23 王水良 一次性自动连发钛夹钳
US9282974B2 (en) * 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
CN103356266B (zh) * 2013-08-05 2015-08-19 杭州康基医疗器械有限公司 一次性钛夹钳同步异向操作装置
WO2016115676A1 (en) * 2015-01-20 2016-07-28 Covidien Lp Surgical clip applier with multiple clip feeding mechanism
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CA2933920A1 (en) * 2015-08-19 2017-02-19 Covidien Lp Surgical clip applier
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US10660651B2 (en) 2016-10-31 2020-05-26 Covidien Lp Endoscopic reposable surgical clip applier
CN206867246U (zh) * 2017-01-17 2018-01-12 上海市第五人民医院 一种腹腔镜专用荷包缝合装置

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CN111248971A (zh) 2020-06-09
US20210338242A1 (en) 2021-11-04
WO2020108302A1 (zh) 2020-06-04
EP3834747C0 (de) 2024-07-24
CN111248971B (zh) 2021-06-29
EP3834747A1 (de) 2021-06-16
US11464519B2 (en) 2022-10-11

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